Chicago BioMedicine takes next steps in reorganization

February 9, 2009

Chicago BioMedicine is taking the next steps in a planned reorganization that will advance its medical and academic missions while lowering overall costs and allowing for a strong and focused response to the economic downturn.

The changes continue the work begun in 2006, when the University of Chicago unified all of its activities in patient care, biomedical research and education, and community health into a single structure, now called Chicago BioMedicine (CBM).

Medical Center CEO James L. Madara, MD, said the current restructuring will increase the connections between different parts of the organization and put it in a better position to meet today's financial challenges.

In December, when financial pressures created by the economic downturn began to accelerate changes already underway, CBM leaders identified the need to cut $100 million from the annual budget. Among the first actions was a reduction of about 15 positions in senior management, announced in early January. A process was created to reassess the contribution of every part of the organization to core missions, in consultation with representatives from across Chicago BioMedicine.

In a letter to the CBM community, Madara wrote, "Our decisions have been directed by our continuing commitment to high-quality, compassionate care for patients with the most challenging diseases; the creation of new knowledge; producing the next generation of leaders; partnering with community-based providers through the Urban Health Initiative; and protecting our high-technology platform for complex patient care and leading-edge research on the South Side of Chicago."

The decisions are designed to make the organization somewhat smaller, but more focused on activities for which it is uniquely suited. Unfortunately that also requires reducing some staff positions. Workforce across all parts of the enterprise will decrease through a balanced combination of attrition and layoffs. Beginning today (February 9), about 450 employees--about 5 percent of the CBM workforce--will be notified that their positions will be eliminated.

"We deeply regret the loss of so many talented employees from our team, especially at such a challenging time in the job market," Madara said. "These colleagues deserve our sincere thanks and utmost respect as they transition in their careers. We will treat them with compassion and do everything we can do to assist them."

In the area of patient care, a major principle guiding the decisions is the need to enhance the Medical Center's focus on providing complex care. The Medical Center has long led the way in complex care, often providing intricate lifesaving procedures that few other institutions could match--such as multiple organ transplants, innovative cardiac surgery and cutting-edge clinical trials for cancer. Some of the planned reductions are based on how units fit within the mission of providing the highest level of complex care; other decisions stem more directly from recent declines in patient volume as a result of the national and local economic downturn.

As a result, overall inpatient capacity will decrease by more than 30 beds. This includes a reduction in beds in general medicine and in the intensive care units, along with staff reductions for those areas. This difficult decision was based partly on the fact that some patients can be treated at other institutions, without the high-technology platform that Chicago BioMedicine provides.

The reorganization also will close two offsite doctors' offices, and relocate most of their services to the Duchossois Center for Advanced Medicine. A surgical unit will reduce weekend services and staffing. Clinical operations also will cut back on outside consultants and standardize supplies in some areas. Housecleaning staff will be reduced for non-patient areas or in clinical units affected by the decrease in patient beds.

Patient units that remain open will keep their current staffing ratios in order to preserve high standards of safety and quality. Contact hours between patients and nursing staff will not be decreased.

The emergency department will be reorganized, with more up-front medical assessment to identify patients with urgent conditions. The institution will make new efforts to redirect patients who do not require emergency care to physician's offices and other facilities. This will include strengthening transfer agreements with other hospitals and clinics. Over time the changes should reduce overall volume in the emergency department and help redistribute demand among a broader set of appropriate providers, Madara said.

Madara noted that implementation of these plans will be refined in consultation with clinical faculty and nursing staff.

In the basic sciences, some staff reductions will come from consolidating administrative duties. The changes will not affect academic programs and no faculty members will be laid off. However, there is a pause in hiring new faculty. The budget reductions will not affect the number of incoming graduate students.

Across the enterprise, faculty positions will be gradually reduced as individuals depart, retire, or are not reappointed at the end of their current contracts.

The largest source of savings from institutional support comes from the already-announced reduction in senior management positions. Administrative reductions also will come from financial personnel, facility design and construction, and reduced budgets for areas such as marketing. Capital spending for construction and renovation projects will be reduced.

Madara emphasized that construction of the New Hospital Pavilion, scheduled for completion in 2012, will go forward. He said the Medical Center's Urban Health Initiative, an effort to strengthen the community health care network on Chicago's South Side and to help patients identify "medical homes" for preventive and routine care, also will continue to be a major priority.

"Even as we look for ways of reducing costs and become more efficient, we must continue to invest in cutting-edge technologies, modern facilities, and strategic initiatives in order to ensure that Chicago BioMedicine can achieve its core missions," Madara said. "Such investments are necessary if we are to continue to provide medical care of the highest quality and safety, conduct agenda-setting research, educate the nation's finest doctors and scholars, and lead the way in biomedicine."